Travel Risk Assessment

Before you complete this form, please visit the Travel Clinic page, as this contains important information on our process for travel vaccinations.

If you are travelling abroad please complete the Risk Assessment below at least 12 weeks before you travel.

Travel Risk Assessment

Section

Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Holiday type:
Type of trip:
Accommodation:
Travelling:
Staying in area which is:
Planned activities:

You should be up to date with routine vaccinations and boosters as recommended in the UK:

  • Diphtheria - Tetanus - Polio (DTP)
  • Measles - Mumps - Rubella (MMR)

The following travel vaccines are available free on the NHS from your GP surgery:

  • Diphtheria - Tetanus - Polio (DTP) - (Combined vaccine)
  • Measles - Mumps - Rubella (MMR)
  • Typhoid
  • Hepatitis A
  • Cholera

If you need any additional vaccinations, you will have to source these from a private travel clinic.

Please only answer the following question after you have done your research as per the cover sheet and our Travel Clinic page.

Tick the vaccines you require:
*